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MD GROUP II LLC NPI 1669416905


NPI Information

NPI: 1669416905
Provider Name: MD GROUP II LLC

Doing Business As: VERONA HOMETOWN PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 52D2128352

Address:
202 S MAIN ST
VERONA, WI
ZIP 53593
Phone: (608) 848-8020
Get Directions

MD GROUP II LLC is a community/retail pharmacy pharmacy in Verona, WI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MD GROUP II LLC NPI is 1669416905. The provider is registered as an organization entity type.
The provider Is Doing Business As Verona Hometown Pharmacy.

The provider's business location address is:

202 S MAIN ST
VERONA, WI
ZIP 53593-422
Phone: (608) 848-8020
Fax: (608) 848-8024

The provider's authorized official is Matthew Mabie .
The authorized official title is Ceo and has the following contact phone number (608) 846-2712.

The CLIA number assigned to this NPI record is 52D2128352 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2006 and was last updated on 11/30/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy8422042WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
133277500MEDICAIDWISCONSIN
25128029OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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